SIBLING ADAPTATION TO CHILDHOOD-CANCER COLLABORATIVE STUDY - HEALTH OUTCOMES OF SIBLINGS OF CHILDREN WITH CANCER

Objective: This seven-site study examined the overall health status, h ealthcare utilization, somatization, and health-risk behaviors of sibl ings of children with cancer compared to these factors in matched cont rols or normative data. The study also examined whether informants (i. e., siblings, parents, physicians) differed in their assessments of th e above health domains. Design: Subjects were 254 siblings of children with cancer from seven different pediatric oncology treatment centers that participated in Sibling Adaptation to Childhood Cancer Collabora tive study group. Predictors of the siblings' health status, healthcar e utilization, somatization, and health-risk behaviors were identified , and the relationship between these health domains and the siblings' resiliency vs. dysfunctionality were explored via interviews. Results: Overall, siblings were found to be moderately healthy, although sibli ngs report significant problems with sleeping and eating. Healthcare u tilization appears to be reduced For siblings. Most importantly, the p arents of these siblings are less likely to seek medical help for a va riety of conditions for which parents of control children would bring their children to a doctor. A pattern emerged of parental underreporti ng of sibling health variables when compared to what the siblings them selves reported. When the relationship between health outcomes and the siblings' adaptation to their sick sibling's illness was examined, th e resilient and dysfunctional groups significantly differed from each other. It appears that health outcomes are related to sibling adaptati on to the changes brought about by their sick sibling's cancer diagnos is and treatment. Conclusions: The focus of care for families of child ren with cancer is often limited to the child with cancer. As indicate d in this study, the ''healthy'' siblings may be overlooked in the pro cess. While parents appear to recognize that their ''healthy'' childre n are complaining more about aches and pains, they may have little ene rgy or time to attend to the needs of these other family members. Ii i s the intent of this study to document what clinicians may expect and to highlight the need for evaluation of this otherwise neglected group . (C) 1996 Wiley-Liss, Inc.